Rachel E Cramton

Interests

Research

pediatric pain,pediatric palliative care,QI,resident and medical student teaching,communicationchild abuse and neglect

Teaching

pediatric pain and palliative care,teaching skills,child abuse and neglect,communication

Courses

Scholarly Contributions

Chapters

• Cramton, R. (2024). Residency Program Calendar- A Year in the Life. In Program Directors' Handbook.
• Cramton, R. (2024). Resident Caregivers. In Program Directors' Handbook.

Journals/Publications

• Zuniga, L., Schuh, A., Schwartz, A., Seo-Mayer, P., Cramton, R., Sieplinga, K., Kaushik, R., Nassetta, L., Homme, J., Babal, J., Mahan, J., & Batra, M. (2023). Burnout During the COVID-19 Pandemic: A Report on Pediatric Residents. Academic Pediatrics, 23(8). doi:10.1016/j.acap.2023.05.004
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  Background and Objective: The Pediatric Resident Burnout and Resilience Consortium (PRB-RSC) has described the epidemiology of burnout in pediatric residents since 2016. We hypothesized burnout rates during the pandemic would increase. We explored resident burnout during the COVID-19 pandemic and its relationship to resident perception of workload, training, personal life, and local COVID burden. Methods: Since 2016, PRB-RSC has sent an annual, confidential survey to over 30 pediatric and medicine-pediatrics residencies. In 2020 and 2021, seven questions were added to explore the relationship of COVID-19 and perceptions of workload, training, and personal life. Results: In 2019, 46 programs participated, 22 in 2020, and 45 in 2021. Response rates in 2020 (n = 1055, 68%) and 2021(n = 1702, 55%) were similar to those of previous years (P = .09). Burnout rates in 2020 were significantly lower than in 2019 (54% vs 66%, P < .001) but returned to pre-COVID levels in 2021 (65%, P = .90). In combined 2020–2021 data, higher rates of burnout were associated with reported increased workload (Adjusted Odds Ratio (AOR) 1.38, 95% CI 1.19–1.6) and concerns regarding the effect of COVID on training (AOR 1.35, 95% CI 1.2–1.53). Program-level county COVID burden in combined 2020–2021 data was not associated with burnout in this model (AOR = 1.03, 95% CI 0.70–1.52). Conclusions: Burnout rates within reporting programs decreased significantly in 2020 and returned to prepandemic levels in 2021. Increased burnout was associated with perceived increases in workload and concerns regarding effect of the pandemic on training. Given these findings, programs should consider further investigation into workload and training uncertainty on burnout.
• Tomaszewski, J. L., Seelbach, E., Potisek, N. M., Pomeroy, B., Patra, K. P., Molas-torreblanca, K., King, M., Harper, B. D., Gourishankar, A., Fromme, H. B., Cramton, R. E., & Buchanan, A. O. (2020). Developing an effective inpatient learning climate.. The clinical teacher, 17(4), 366-372. doi:10.1111/tct.13121
• Cramer, N., Shwaish, N., Elliott, S. P., Franke, H. A., Seserinac, J., & Cramton, R. (2017). A QI Project to Improve Resident Satisfaction and Participation in Pediatric Board Examination Review. Academic Pediatrics, 17(5), e14-e15.
• Gruchala, N. E., & Cramton, R. E. (2013). Babies breaking bad: neonatal and iatrogenic withdrawal syndromes.. Current opinion in pediatrics, 25(4), 532-42. doi:10.1097/mop.0b013e328362cd0d
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  This review will summarize the symptoms, evaluation, and treatment of neonatal and iatrogenic withdrawal syndromes..Buprenorphine is emerging as the drug of choice for maintaining opioid-dependent women during pregnancy, because of its association with less severe withdrawal symptoms. Recent findings suggest it may be the drug of choice for treating the opioid-exposed neonate as well..Healthcare workers should be cognizant of the risk factors for neonatal abstinence syndrome (NAS), as well as its symptoms, so that nonpharmalogic and pharmacologic therapies can be initiated. With increased emphasis on pain control in children, it is likely that iatrogenic withdrawal will continue to be a concern, and healthcare workers should understand the similarities and differences between this and NAS.
• Gruchala, N. E., & Cramton, R. E. (2012). Managing procedural pain in pediatric patients.. Current opinion in pediatrics, 24(4), 530-8. doi:10.1097/mop.0b013e328355b2c5
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  To review recent research on the management of acute procedural pain in pediatric patients..Pediatric patients experience pain with the same or greater intensity as their adult counterparts. Recent studies have acknowledged the importance of people's beliefs about pain and of a multidisciplinary approach to the assessment and treatment of acute pain..Pediatric patients experience pain from procedures related to their care. Pediatricians should educate themselves regarding the accurate assessment of pain, and the pharmacologic and nonpharmacologic methods of managing acute pain.
• Whalen, B. L., & Cramton, R. E. (2010). Overcoming barriers to breastfeeding continuation and exclusivity.. Current opinion in pediatrics, 22(5), 655-63. doi:10.1097/mop.0b013e32833c8996
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  To review recent research that delineates predictors of breastfeeding duration and exclusivity..Many mothers find it difficult to meet personal goals and follow expert recommendations for continued and exclusive breastfeeding despite increased rates of initiation. Recent studies have revealed varied sociodemographic, biomedical, and psychosocial determinants of breastfeeding duration and exclusivity..In order to help mothers meet personal goals and expert recommendations for breastfeeding, pediatricians should educate themselves regarding predictors of and barriers to successful breastfeeding. Once these predictors and barriers have been identified, targeted anticipatory guidance can be provided to help mothers achieve breastfeeding success.
• Cramton, R. E., Whalen, B. L., & Zain-ul-Abideen, M. (2009). Optimizing successful breastfeeding in the newborn. Current Opinion in Pediatrics. doi:10.1097/mop.0b013e32832b325a
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  The purpose of this article is to present an overview of the state of breastfeeding in the United States and to examine recent evidence for strategies aimed at optimizing successful breastfeeding in the neonatal period.Although rates of any and exclusive breastfeeding are rising, American mothers and infants are still unable to meet the Healthy People 2010 objectives. A review of the current literature demonstrates that the 'Ten Steps to Successful Breastfeeding' and the Baby Friendly Hospital Initiative are effective measures to increase breastfeeding initiation, duration, and exclusivity. A recent national survey reveals a significant proportion of pediatricians are not providing evidence-based recommendations for breastfeeding guidance and support.The Baby Friendly Hospital Initiative, based upon the 'Ten Steps to Successful Breastfeeding', is an effective evidence-based model of perinatal care that protects, promotes, and supports breastfeeding. Pediatricians should aim to provide anticipatory guidance and management consistent with the 'Ten Steps' to optimize breastfeeding outcomes for mothers and their newborns.

Presentations

• Cramton, R. (2024, April). Minor Sex Trafficking. Peds in the Desert.
• Cramton, R. (2024, August). Speaking for Patients Who Cannot Speak for Themselves – Non-Accidental Trauma in Children. Southwest Regional Trauma Conference. Tucson, AZ.
• Beider, S., & Cramton, R. (2021, Spring). COVID Pivot: Offering TeleHealth to Healthcare Providers, Hospitalized Kids, and Families in Need. Integrative Medicine and Health SymposiumAcademic Consortium for Integrative Medicine and Health.
• Weber, G., Weinberger, K., & Cramton, R. (2021, Spring). Trainees on the Frontlines. UACOM Research Day Data Blitz.
• Ricker, M. A., Cramton, R., & Lebensohn, P. (2020, January). Writing in Wellbeing in Medicine.. National Conference on Writing and Wellbeing. Tucson, AZ.: University of Arizona, Department of English.
• Pottinger, H. L., Beider, S., Duncan, B. R., Schwartz, G. E., Frazee, K., Angulo, B., Cramton, R., & Ehiri, J. E. (2017, November). Integrative Wellness Sessions in a Children’s Hospital Setting: A Feasibility Study to Assess the Hospital Heroes Program at Banner’s Diamond Children’s Hospital. American Public Health Association (APHA). Atlanta, GA.

Poster Presentations

• Cramton, R., Lee, S. T., Reed, s., Rasmussen, L., Ponitz, K., Elliott, S., Serwint, J., Burke, A., Tancredi, D., Ben-Zion, S., Rana, D., & Sox, C. (2024, April). Correlation between Wellbeing milestone, Resilience, Perceived Burnout and Stress. Association of Pediatric Program Directors Spring Meeting. Chicago, IL.
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  S.T. Li, L.N. Rasmussen, S. Reed, K. Ponitz, J.R. Serwint, C. Sox, R. Cramton, D.T. Rana, S.P. Elliott, D.J. Tancredi, A.E. Burke, S. Ben-Zion. “Correlation Between Well-Being Milestone, Resilience, Perceived Stress and Burnout”. Poster Presentation. Pediatric Academic Societies Meeting. 2024, May 6; Toronto, Canada.
• Cramton, R., Lee, S. T., Reed, s., Rasmussen, L., Ponitz, K., Elliott, S., Serwint, J., Burke, A., Tancredi, D., Ben-Zion, S., Rana, D., & Sox, C. (2024, April). Pediatric Program Assessment of Well-Being Milestone. Association of Pediatric Program Directors Spring Meeting. Chicago, IL.
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  S.T. Li, D.J. Tancredi, K. Ponitz, J.R. Serwint, C. Sox, R.E.M. Cramton, D. Rana, S.P. Elliott, A.E. Burke, S. Reed, S. Ben-Zion, L.N. Rasmussen. “Pediatric Program Assessment of Well-Being Milestone”. Poster Presentation. Pediatric Academic Societies Meeting. 2024, May 4; Toronto, Canada.
• Cramton, R., Lee, S. T., Reed, s., Rasmussen, L., Ponitz, K., Elliott, S., Serwint, J., Burke, A., Tancredi, D., Ben-Zion, S., Rana, D., & Sox, C. (2024, May). Correlation between Wellbeing milestone, Resilience, Perceived Burnout and Stress. Pediatric Academic Societies. Toronto, CANADA.
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  S.T. Li, L.N. Rasmussen, S. Reed, K. Ponitz, J.R. Serwint, C. Sox, R. Cramton, D.T. Rana, S.P. Elliott, D.J. Tancredi, A.E. Burke, S. Ben-Zion. “Correlation Between Well-Being Milestone, Resilience, Perceived Stress and Burnout”. Poster Presentation. Pediatric Academic Societies Meeting. 2024, May 6; Toronto, Canada.
• Cramton, R., Lee, S. T., Reed, s., Rasmussen, L., Ponitz, K., Elliott, S., Serwint, J., Burke, A., Tancredi, D., Ben-Zion, S., Rana, D., & Sox, C. (2024, May). Pediatric Program Assessment of Well-Being Milestone. Pediatric Academic Societies. Toronto, CANADA.
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  S.T. Li, D.J. Tancredi, K. Ponitz, J.R. Serwint, C. Sox, R.E.M. Cramton, D. Rana, S.P. Elliott, A.E. Burke, S. Reed, S. Ben-Zion, L.N. Rasmussen. “Pediatric Program Assessment of Well-Being Milestone”. Poster Presentation. Pediatric Academic Societies Meeting. 2024, May 4; Toronto, Canada.
• Weinberger, K., & Cramton, R. (2021, Summer). Addressing the Need for an End of Life Curriculum for Pediatric Residents. Arizona AAP in the Red Rocks. Sedona, AZ: American Academy of Pediatrics- Arizona Chapter.
• Weinberger, K., Chen, N., Cramton, R., Cramton, R., Weinberger, K., & Chen, N. (2021, February 2021). Addressing the Need for an End of Life Curriculum for Pediatric Residents. Innovations in Medical Education. Virtual Conference: USC Keck School of Medicine.
• Weinberger, K., Weber, G., & Cramton, R. (2021, Summer). Trainees on the Frontlines: Impact of a Pandemic on Residents, Fellows and Medical Students. Arizona AAP Pediatrics in the Red RocksAmerican Academy of Pediatrics- Aruzona Chapter.
• Elliott, S. P., Cramer, N., Zahedieh, S., Franke, H. A., Seserinac, J., & Cramton, R. (2017, April). ‘Practice Makes Perfect’: A Study Comparing Clustered Vs. Daily Flashcard Review and Medical Knowledge Retention. APPD Spring Meeting. Anaheim, CA: Association of Pediatric Program Directors.

Creative Productions

• Cramton, R. (2020. Stories of Connection: Storytelling Event. Virtual due to COVID.

Other Teaching Materials

• Cramton, R. (2021. Conversations on Healing with Shay Beider. Integrative Touch for Kids.
• Cramton, R., & Behar, s. (2021. Difficult Conversations. Hippo Education- Peds RAP.
• Cramton, R. (2017. Adolescent Medicine. Hippo Education.
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  Prepared and presented content on adolescent medicine for Hippo Education's subscription video series on Pediatric Core Content.

Others

• Cramton, R., Whitmer, R., & Anderson, K. (2024, February). The Rot at the Root: How a lack of parental leave for medical stduents inpacts the future. Gold Foundation Summit.